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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414004260
Report Date: 01/10/2024
Date Signed: 01/10/2024 12:11:18 PM

Document Has Been Signed on 01/10/2024 12:11 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BRUNO CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME:EDISON MONTESSORI SCHOOLFACILITY NUMBER:
414004260
ADMINISTRATOR:ANGELA TANGFACILITY TYPE:
850
ADDRESS:303 TWIN DOLPHIN DRIVE, # 104TELEPHONE:
(650) 593-6824
CITY:REDWOOD CITYSTATE: CAZIP CODE:
94065
CAPACITY: 45TOTAL ENROLLED CHILDREN: 45CENSUS: 32DATE:
01/10/2024
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
11:15 AM
MET WITH:Angela TangTIME COMPLETED:
12:20 PM
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On 1/10/2024 at 11:15AM Licensing Program Analyst (LPA) Luis J. Gomez met with Angela Tang. Purpose of the inspection was explained and was for an unannounced, plan of correction inspection established on 11/2/2023. Present was the director and four staff supervising 32 children. Children present had been signed in. LPA inspected facility for health and safety hazards.

During inspection, LPA observed staff providing direct supervision in areas of the classroom.


Per director, staff now are expected to accompany children to the bathroom, and also listening to the children’s needs.

Deficiency issued on 11/2/2023, have been cleared, and ‘Cleared Plan of Correction Letter’ was provided.

Exit interview, and inspected report was discussed with Director, Angela Tang. Signature of this form acknowledges receipt of these documents.

This report must be available in the facility for public review. Notice was provided and shall remain posted for 30 days. Director was advised for additional questions to call CCL Office, M-F, 8am-5pm, 650-266-8800 or 1-844-538-8766. Website: www.ccld.ca.gov
SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Luis Gomez
LICENSING EVALUATOR SIGNATURE: DATE: 01/10/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/10/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
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